Port Alberni Palliative Resources. Kelly Weber BSN, CHPCN Palliative Care Coordinator Port Alberni/West Coast

Transcription

1 Port Alberni Palliative Resources Kelly Weber BSN, CHPCN Palliative Care Coordinator Port Alberni/West Coast

2 Objectives Review Assessment Tools Review Palliative Resources British Columbia Port Alberni

3 PA Palliative Stats 2011 number of patient deaths on palliative program: 76 Location of death: WCGH: 41 = 54% Community: 32 = 42% Home: 13 = 17% Ty Watson House: 19 = 25%

4 End of Life Assessment Tools Palliative Performance Scale Pain and Symptom Diary Edmonton System Assessment Tool (ESAS)

5 Palliative Performance Scale 11-point scale used to measure performance over time Helps to plan changing care needs Designed for cancer patients but helpful with chronic illness Communication tool Doesn t measure patient distress/suffering

6 A Circle of Care SOCIETY Palliative Performance Scale (PPSv2) version 2 PPS Level Ambulation Activity & Evidence of Disease Self-Care Intake Conscious Level 100% Full Normal activity & work No evidence of disease Full Normal Full 90% Full Normal activity & work Some evidence of disease Full Normal Full 80% Full Normal activity with Effort Some evidence of disease Full Normal or reduced Full 70% Reduced Unable Normal Job / Work Significant disease Full Normal or reduced Full 60% Reduced Unable hobby / house work Significant disease Occasional assistance necessary Normal or reduced Full Or Confusion 50% Mainly Sit / Lie Unable to do any work Extensive disease Considerable assistance Required Normal or reduced Full Or Confusion 40% Mainly in Bed Unable to do most activity Extensive disease Mainly assistance Normal or reduced Full or Drowsy +/- Confusion 30% Totally Bed Bound Unable to do any activity Extensive disease Total Care Normal or reduced Full or Drowsy +/- Confusion 20% Totally Bed Bound Unable to do any activity Extensive disease Total Care Minimal to Sips Full or Drowsy +/- Confusion 10% Totally Bed Bound Unable to do any activity Extensive disease Total Care Mouth care only Drowsy or Coma +/- Confusion 0% Death

7 Pain and Symptom Diary

8 Edmonton Symptom Assessment Scale (ESAS)

9 Let s meet the patient 66 year old married man, retired school teacher diagnosed with metastatic lung cancer to bone. No further chemo/radiation treatments and recently been told he is palliative. Presents to office with increased hip pain and SOB, unsteady on feet, fatigue+ What s his PPS? Next steps?

10 End of Life Resources BC Palliative Care Benefits Forms NO CPR Form Notification of Expected Death Form Death Certificate

11 BC Palliative Benefits Program 2 parts medications and equipment/supplies Prognosis 6 months or less PPS 50% or less H&CC provides equipment/supplies HCN, Rehab, SW, Home Support

12 NO CPR Form Must be signed by Physician Valid for 12 months Copy for patient (keep on fridge) and HCN Needed for home death Medic-alert bracelets available (free)

13 Notification of Expected Death Signed by physician Copy in patient home and funeral home Death pronouncement not needed Family will call funeral home for transport after death Funeral home will contact physician for death certificate

14 GP Supports 24 hr Palliative Hotline NRGH Palliative GP on call Victoria Hospice Palliative Doctor on call Don t forget about local supports.. Dr. Johnsen Palliative Coordinator

15 Palliative Physician Member of TWH Pharmacy Committee Attends q2week palliative rounds Provides evening and weekend support to palliative patients Formal and informal education PA/West Coast Attends VI Palliative Network meetings

16 H&CC Palliative Coordinator Plans, coordinates, teaches, promotes and evaluates best practice for palliative care Promotes continuum between community and hospital Educates and mentors staff Home visits, complex situations Collaborates and consults with various teams, committees

17 Ty Watson House 4 bedrooms with shared bathroom Must be on HCN palliative program (RN available 24 hrs/day) Symptoms must be stable No communicable disease $30.00 per day (negotiable) 24 hr Community Health Worker Hospice provides hospitality service Palliative drug box

18 In closing Refer palliative patients early to H&CC PPS 50% Contact Dr. Johnsen or Palliative Coordinator for more information